Provider Demographics
NPI:1437993987
Name:AFFINITY PHYSICAL THERAPY SC INC
Entity type:Organization
Organization Name:AFFINITY PHYSICAL THERAPY SC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:REBMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-680-1278
Mailing Address - Street 1:736 FIORSHEIM DRIVE
Mailing Address - Street 2:SUITE 13
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-3704
Mailing Address - Country:US
Mailing Address - Phone:847-680-1278
Mailing Address - Fax:847-680-2026
Practice Address - Street 1:736 FIORSHEIM DRIVE
Practice Address - Street 2:SUITE 13
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3704
Practice Address - Country:US
Practice Address - Phone:847-680-1278
Practice Address - Fax:847-680-2026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy